Healthcare Provider Details

I. General information

NPI: 1245313832
Provider Name (Legal Business Name): STACEY LYNNE YEO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY L RICHMOND NP

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 S LAFOUNTAIN ST
KOKOMO IN
46902-3803
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 765-776-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number71002266A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number71002266
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: